In the Realm of Hungry Ghosts

In this timely and profoundly original new book, bestselling writer and physician Gabor Maté looks at the epidemic of addictions in our society, tells us why we are so prone to them and what is needed to liberate ourselves from their hold on our emotions and behaviours.For over seven years Gabor Maté has been the staff physician at the Portland Hotel, a residence and harm reduction facility in Vancouver's Downtown Eastside. His patients are challenged by life-threatening drug addictions, mental illness, Hepatitis C or HIV and, in many cases, all four. But if Dr. Maté's patients are at the far end of the spectrum, there are many others among us who are also struggling with addictions. Drugs, alcohol, tobacco, work, food, sex, gambling and excessive inappropriate spending: what is amiss with our lives that we seek such self-destructive ways to comfort ourselves? And why is it so difficult to stop these habits, even as they threaten our health, jeopardize our relationships and corrode our lives?Beginning with a dramatically close view of his drug addicted patients, Dr. Maté looks at his own history of compulsive behaviour. He weaves the stories of real people who have struggled with addiction with the latest research on addiction and the brain. Providing a bold synthesis of clinical experience, insight and cutting edge scientific findings, Dr. Maté sheds light on this most puzzling of human frailties. He proposes a compassionate approach to helping drug addicts and, for the many behaviour addicts among us, to addressing the void addiction is meant to fill.I believe there is one addiction process, whether it manifests in the lethal substance dependencies of my Downtown Eastside patients, the frantic self-soothing of overeaters or shopaholics, the obsessions of gamblers, sexaholics and compulsive internet users, or in the socially acceptable and even admired behaviours of the workaholic. Drug addicts are often dismissed and discounted as unworthy of empathy and respect. In telling their stories my intent is to help their voices to be heard and to shed light on the origins and nature of their ill-fated struggle to overcome suffering through substance use. Both in their flaws and their virtues they share much in common with the society that ostracizes them. If they have chosen a path to nowhere, they still have much to teach the rest of us. In the dark mirror of their lives we can trace outlines of our own.—from In the Realm of Hungry Ghosts

Author's NoteHungry Ghosts: The Realm of AddictionPART I: HELLBOUND TRAIN1.The Only Home He's Ever Had2.The Lethal Hold of Drugs3.The Keys of Paradise4.You Wouldn't Believe My Life Story5.Angela's Grandfather6.Pregnancy Journal7.Beethoven's Birth Room8.There's Got to Be Some Light PART II: PHYSICIAN, HEAL THYSELF9.Takes One to Know One10.Twelve-Step JournalPART III: A DIFFERENT STATE: THE ADDICTED BRAIN11.What Is Addiction?12.From Vietnam to ?Rat Park?13.A Different State of the Brain14.Through a Needle, a Warm Soft Hug15.Cocaine, Dopamine and Candy Bars16.Like a Child Not ReleasedPART IV: HOW THE ADDICTED BRAIN DEVELOPS17.Their Brains Never Had a Chance18.Trauma, Stress and the Biology of Addiction19.It's Not in the GenesPART V: THE ADDICTION PROCESS AND THE ADDICTIVE PERSONALITY20.?A Void I'll Do Anything to Avoid?21.Too Much Time on External Things22.Poor Substitutes For LovePART VI: IMAGINING A HUMANE REALITY: BEYOND THE WAR ON DRUGS 23.Dislocation and the Social Roots of Addiction24.Know Thine Enemy25.A Failed War26.Freedom of Choice and the Choice of Freedom 27.Imagining an Enlightened Social Policy on Drugs28.A Necessary Small Step: Harm ReductionPART VII: THE ECOLOGY OF HEALING 29.The Power of Compassionate Curiosity30.The Internal Climate31.The Four Steps, Plus One32.Sobriety and the External Milieu33.A Word to Families, Friends and Caregivers34.There Is Nothing LostMemories and Miracles: An EpiloguePostscriptAppendicesi:Adoption and Twin Study Fallaciesii:A Close Link: Attention Deficit Disorder and Addictionsiii:The Prevention of Addictioniv:The Twelve StepsEndnotesAcknowledgmentsPermissionsIndex